It has long been recognized that it is of vital importance to stabilize the head and cervical portions of accident victims or those who are suspected of having been exposed to cervical injuries. It is well understood that very serious and permanent damage can be done by movement of the head and cervical portions when damage has occurred in the cervical region. Accordingly, with accident victims or others in whom possibility of head or cervical injury exists, the paramedical staff attending the patient at the site and during transference to a medical treatment facility routinely immobilize the head and cervical spinal area of such a patient to attempt to reduce any further injury. Similarly upon arrival of accident victims or the like at a medical treatment facility, medical staff then must assess the patient while ensuring that no additional damage is done during the assessment process. Often the assessment process may involve use of other sophisticated medical equipment located in other areas of the hospital or treatment facility other than the emergency or receiving room. This may involve moving the patient to be subjected to x-ray evaluation or CT scans and the like. During the medical evaluation procedure it is important and desirable that full access be had to the head and cervical area of the patient without moving the patient.
There have been many devices intended to maintain support for the head of a patient during the transport phase from accident scene to medical treatment facility. U.S. Pat. No. 4,182,322 issued Jan. 8, 1980 to Miller discloses a durable lightweight three section cushion which is used to effectively cover and restrain the head of the accident victim when placed on a body splint or a back board. The cushion presents a substantially box-like structure extending over the top of the patient's head and along either side. Straps are positioned across the forehead and jaw of the patient.
U S. Pat. No. 4,297,994 issued Nov. 3, 1981 to Beeshaw illustrates a similar device in which a pair of relatively large rectangular blocks are positioned on either side of the patient's head extending from adjacent the shoulder to above the top of the head. A strap extending across the top of the head connects the two blocks. Immobilization straps may then be placed running across the patient's forehead and jaw extending from the outside surfaces of the square blocks.
U.S. Pat. No. 4,528,981 issued Jul. 16, 1985, to Behar illustrates a cervical immobilization device comprising a pair of cylindrical support rolls one extending on either side of the head, the axis of the roll extending substantially parallel to the spine. Straps extending from each roll cross over the patient's forehead and jaw to maintain the location of the head and to stabilize against movement.
There have also been a number of proposals for use of relatively cheap, reasonably disposable supports made from a single piece of material such as corrugated material, sheet plastic, cardboard or other material which is light in weight and which can be folded for storage and use. One example of this type of device is illustrated in U.S. Pat. No. 4,928,711 issued May 29, 1990 to Williams. The Williams device includes a pair of laterally extending side support panels. Each of the side panels includes an inner panel and an outer panel with the inner panel being conformable to a shape necessary to support the head of the patient. The inner panel also includes an opening which divides a portion of that inner panel into a pair of spaced support members which extend laterally from the base. The outer panel has inner and outer edges and is attached by a hinge to the inner panel such that it is foldable relative to the inner panel to provide a substantially rigid brace for securing the inner panel in the desired immobilizing position. The outer panel also includes a cut out portion for providing substantial access to the opening of the inner panel when in the braced configuration.
While many of the prior devices are effective to stabilize the head and cervical region of the spine against movement during transport the head supporting structure does not allow for assessment by medical staff. Typically, when there is injury in the region of the head or in the region of the neck it is desirable to have access to the ear so as to be able to view bleeding from the ear or discharge from the ear and the like which may be useful in assessing medical conditions. With prior art structures that involve rolls, blocks or panels that extend along the side of the head it becomes impossible to assess for head injuries and the like without removing the supporting structure. Thus, before any detailed assessment can be carried out the head immobilizing structure must be removed and some different structure installed in its place during that initial assessment. It is also desirable in many instances to be able to use the standard forms of cervical collar to provide support for the patient's cervical region while also immobilizing the head. It is often desirable to provide the cervical collar rather than simply immobilizing the head. Thus it is desirable that a head immobilizing structure permit the use of a cervical collar.
One of the major areas which devices as referred to above and many others of this type do not address is the question of the elevation of the head. Different body configurations will result in different alignments of the spine when the patient is placed on a hard supporting surface such as a back board or stretcher. Depending upon the configuration of the patient's back, the head may in fact tip backward thus bending the cervical spine backward before the head contacts the surface of the backboard. In these situations the paramedical staff must insert pillows, cushions or other supports underneath the back of the head in an attempt to ensure that the spine is aligned in its natural alignment when viewed horizontally. The placing of pillows, cushions or supports under the back of the head then is a further step requiring handling of the head by the paramedical staff and may interfere with the proportions, angles and other support structure of the head immobilizing device.